闭合性胰腺损伤的诊断与治疗

Diagnosis and Treatment of Blunt Pancreatic Injuries

目的:探讨闭合胰腺性损伤诊断和治疗方法,提高其诊断、治疗水平。方法:回顾性分析2003年1月～2008年2月间22例闭合性胰腺损伤的一般资料、致伤原因、诊疗经过与预后。结果:交通事故车祸伤14例,坠落伤4例,击打伤4例。合并伴发伤18例;CT诊断符合率为52.9%;22例均行手术治疗,手术采用清创加引流11例,简单胰腺缝合加引流5例,主胰管结扎加外引流2例,胰腺体尾部联合脾脏切除2例,节段性胰腺切除加远端胰空肠吻合2例。治愈21例,死亡1例;术后4例发生胰瘘,为最常见并发症(18.2%)。结论:CT及血淀粉酶检查对胰腺损伤有一定的诊断价值。术中关键是保持警惕,探查全面,按胰腺损伤情况选择适当的治疗方法是提高治愈率的关键。

Objective： To study the method of diagnosis and treatment for Blunt pancreatic injuries. Methods： From January 2003 to Febmary 2008, the data of clinical course,injury classification, diagnostic methods,surgical management and outcomes of 22 patients Mth pancreatic trauma were retrospectively analyzed. Results： Among the 22 patients with pancreatic trauma, Traffic accident was the major cause of injury. 18 patients were complicated with other injuries. The accordance rate of CT diagnosis was 52. 9%. Operation were performed on all 22 cases. Operatire procedures included debridement and extemaldrainage in 11 patients,simple suture repair and extemaldrainage in 5 imajer duct ligatian and exteraaldrainage in 2, distal pancreatectomy with splenectomy in 2, regional panereateetomy and distal pancreatojejunostomy in 2.21 cases were recovery and 1 case was dead. The most complications was pancreatic fistula（ 18.2% ）. Conclusion ： CT and blood amylase check＇up were important to the diagnosis of blunt pancreatic injuries. Selecting a reasonable surgical Operation method according to the situation of pancreatic injuries during the surgical operation can elevate successful rate.